One great feature of using Epic's Beaker LIS is the seamless integration with the rest of the EHR. In this post, I'll outline how the lab can take advantage of this integration to be alerted if the patient is taking medications of interest. This often gets missed during the implementation so is a great (and rather simple) EHR optimization.
Data entered in Epic doesn't need to cross an interface to be available in Beaker. Beaker *is* Epic - one central database, centered around the patient. This can be incredibly powerful and can improve patient care in ways previously impossible with an interfaced LIS. One powerful example of this integration is the ability to see pertinent medication information in the lab. In this post we'll highlight a few examples that can be good EHR optimization projects.
Darzalex for Blood Bank Testing
Darzalex® (daratumumab) is a human monoclonal antibody that can be given to patients being treated for multiple myeloma. The antibody binds CD38 on RBCs which can cause agglutination, and in turn, false positives for antibody screening and crossmatching. This blood compatibility testing interference can be mitigated, however, so long as the lab knows that the patient is on the medication. One way is by pre-treating cells with dithiothreitol (PubMed article here). Your lab will certainly have a protocol that they follow - we just need to make sure they are alerted that the patient is on the medication. The build in Beaker would simply include a rule that would search through the patient's current medications and fire a flag and could fire a flag that would be visible when the blood bank receives the specimen in Beaker. To be even more user friendly, perhaps, you could also use a switch label to print some indication that the patient is on the medicaiton on the specimen label - something that would catch the eye of receiving staff.
Anticoagulants for Coag Testing
Similar to the antibiotics example above, you can flag coag specimens collected from patients on an anti-coagulant, such as heparin or warfarin. To broadly catch all anticoagulants, you can use the pharmaceutical class of anticoagulants. You'll likely want to exclude any heparin flushes, though, from your rule. Your Willow colleagues should be able to help you craft your rule.
Antibiotics for Microbiology Testing
You can alert your micro folks if a patient is currently on antibiotics. This example likely won't require any work as it is standardly built out in Epic. I call it out, though, because you can use the Foundation rule and FYI build to accomplish this as a template for other medications.
What other medication alerts do you have built out in Epic? Feel free to add them in the comments below. Also, if you have any issues building this out, feel free to get in touch with me.
